Write your message
Volume 7, Issue 3 (May & June 2022)                   J Obstet Gynecol Cancer Res 2022, 7(3): 158-164 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Elmizadeh K, Naghdipour M, Lalooha F, Hosseini Valmi S M, Massoudifar A, Sarafraz M. Comparing the Outcomes of Fast-Track Hysterectomy and Routine Abdominal Hysterectomy. J Obstet Gynecol Cancer Res. 2022; 7 (3) :158-164
URL: http://jogcr.com/article-1-455-en.html
1- Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences, Qazvin, Iran
2- Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran , misa.npm@gmail.com
3- Department of Anesthesiology, Qazvin University of Medical Sciences, Qazvin, Iran
4- Department of Psychiatry, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract:   (523 Views)

Background & Objective: Hysterectomy is one of the major gynecologic operations. This procedure can be performed by different methods including abdominal, vaginal, and laparoscopic hysterectomy. In fast-track hysterectomy (FTH), patients do not receive opioids during surgery and there is no need for a 12-hour pre-surgery hospitalization. Patients are encouraged to eat and move at most 6 hours after operation. This study was performed to compare the outcomes of FTH with those of routine abdominal hysterectomy (RAH).
Materials & Methods: This case-control pilot study was carried out on 82 candidates for hysterectomy at Kowsar Training Hospital in Qazvin, Iran, during 2016. Patients were divided into two randomized groups of FTH and RAH. Parameters such as pain visual analogue scale (VAS) after 3, 6, 12, and 24 hours, diet tolerance, analgesic dose, postoperative nausea and vomiting, hospital stay, postoperative adverse effects, gas passing time, and readmission were investigated and compared between two groups.
Results: Analgesic use, gas passing time, and hospital stay were significantly lower in the FTH group (P=0.0001). While postoperative nausea and vomiting, adverse effects, food tolerance, and readmission rate were the same in both groups (P>0.05). Moreover, diet tolerance was observed in all patients. In general, pain VAS was lower in FTH with significant difference at 3rd (P=0.002) and 12th (P=0.001) hours, and at suture removal time (P=0.026).
Conclusion: It can be concluded that FTH may result in reduced pain, analgesic use, gas passing time, and hospital stay in comparison with RAH.

Full-Text [PDF 231 kb]   (118 Downloads) |   |   Full-Text (HTML)  (63 Views)  
Systematic Review: Original Research | Subject: Obstetrics and Gynecology
Received: 2021/07/25 | Accepted: 2021/09/7 | Published: 2022/01/12

1. Gorlero F, Lijoi D, Biamonti M, Lorenzi P, Pullè A, Dellacasa I, et al. Hysterectomy and women satisfaction: total versus subtotal technique. Arch Gynecol Obstet. 2008;278(5):405. [DOI:10.1007/s00404-008-0615-6] [PMID]
2. Persson P, Hellborg T, Brynhildsen J, Fredrikson M, Kjølhede P. Attitudes to mode of hysterectomy-a survey‐based study among Swedish gynecologists. Acta Obstet Gynecol Scand. 2009;88(3):267-74. [DOI:10.1080/00016340802649824] [PMID]
3. Köhler C, Hertel H, Herrmann J, Marnitz S, Mallmann P, Favero G, et al. Laparoscopic radical hysterectomy with transvaginal closure of vaginal cuff-a multicenter analysis. Int J Gynecol Cancer. 2019;29(5). [DOI:10.1136/ijgc-2019-000388] [PMID]
4. Dedden SJ, Geomini PM, Huirne JA, Bongers MY. Vaginal and laparoscopic hysterectomy as an outpatient procedure: a systematic review. European J Obstet Gynecol Reprod Biol. 2017;216:212-23. [DOI:10.1016/j.ejogrb.2017.07.015] [PMID]
5. Lundin ES, Carlsson P, Wodlin NB, Nilsson L, Kjölhede P. Cost-effectiveness of robotic hysterectomy versus abdominal hysterectomy in early endometrial cancer. Int J Gynecol Cancer. 2020;30(11). [DOI:10.1136/ijgc-2020-001611] [PMID]
6. Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Sys Rew. 2006. [DOI:10.1002/14651858.CD003677.pub2]
7. Jin J, Min S, Peng L, Du X, Zhang D, Ren L. No differences in the prevalence and intensity of chronic postsurgical pain between laparoscopic hysterectomy and abdominal hysterectomy: a prospective study. J Pain Res. 2020;13:1. [DOI:10.2147/JPR.S225230] [PMID] [PMCID]
8. Louie M, Strassle PD, Moulder JK, Dizon AM, Schiff LD, Carey ET. Uterine weight and complications after abdominal, laparoscopic, and vaginal hysterectomy. Am J Obstet Gynecol. 2018;219(5):480. e1-. e8. [DOI:10.1016/j.ajog.2018.06.015] [PMID]
9. Ramdhan RC, Loukas M, Tubbs RS. Anatomical complications of hysterectomy: A review. Clin Anat. 2017;30(7):946-52. [DOI:10.1002/ca.22962] [PMID]
10. Shehmar M, Gupta J. The influence of psychological factors on recovery from hysterectomy. J Royal Soc Med. 2010;103(2):56-9. [DOI:10.1258/jrsm.2009.090198] [PMID] [PMCID]
11. Ammianickal PL, Thangaswamy CR, Balachander H, Subbaiah M, Kumar NP. Comparing epidural and wound infiltration analgesia for total abdominal hysterectomy: A randomised controlled study. Indian J Anaesth. 2018;62(10):759. [DOI:10.4103/ija.IJA_124_18] [PMID] [PMCID]
12. REHMAN B, Farooqi A. Analgesic efficacy of pre-emptive oral flupirtine maleate for post-operative analgesia after total abdominal hysterectomy under general anaesthesia. JMS SKIMS. 2020;23(Suppl 1).
13. Wijk L. Enhanced Recovery After Hysterectomy: Örebro University; 2017.
14. Carter J, Szabo R, Sim WW, Pather S, Philp S, Nattress K, et al. Fast track surgery: a clinical audit. Aust N Z J Obstet Gynaecol. 2010;50(2):159-63. [DOI:10.1111/j.1479-828X.2009.01134.x] [PMID]
15. Varadhan KK, Lobo DN, Ljungqvist O. Enhanced recovery after surgery: the future of improving surgical care. Crit Care Clin. 2010;26(3):527-47. [DOI:10.1016/j.ccc.2010.04.003] [PMID]
16. Kjølhede P, Langström P, Nilsson P, Wodlin NB, Nilsson L. The impact of quality of sleep on recovery from fast-track abdominal hysterectomy. Journal of clinical sleep medicine: JCSM: Official Pub Am Academy Sleep Med. 2012;8(4):395. [DOI:10.5664/jcsm.2032] [PMID] [PMCID]
17. Wilmore DW, Kehlet H. Management of patients in fast track surgery. Bmj. 2001;322(7284):473-6. [DOI:10.1136/bmj.322.7284.473] [PMID] [PMCID]
18. Nüssler EK. Surgical quality control of minimally invasive procedures, fast-track surgery and implant technology in gynaecological surgery in Sweden: Umeå Universitet; 2019.
19. Kehlet H. Fast-track colorectal surgery. The Lancet. 2008;371(9615):791-3. [DOI:10.1016/S0140-6736(08)60357-8]
20. White PF, Kehlet H, Neal JM, Schricker T, Carr DB, Carli F, et al. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth Analgs. 2007;104(6):1380-96. [DOI:10.1213/01.ane.0000263034.96885.e1] [PMID]
21. Holte K, Kehlet H. Fluid therapy and surgical outcomes in elective surgery: a need for reassessment in fast-track surgery. J Am College Surg. 2006;202(6):971-89. [DOI:10.1016/j.jamcollsurg.2006.01.003] [PMID]
22. Wind J, Polle S, Fung Kon Jin P, Dejong C, Von Meyenfeldt M, Ubbink D, et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J surg. 2006;93(7):800-9. [DOI:10.1002/bjs.5384] [PMID]
23. Nawaz S, Mushtaq N. Outcome of Fast Track Surgery (FTS) or Enhanced Recovery after Surgery (ERAS) in Major Gynecological Surgeries. J Rawalpindi Med College. 2018;22:168-70.
24. Kroon U-B, Rådström M, Hjelthe C, Dahlin C, Kroon L. Fast-track hysterectomy: a randomised, controlled study. Eur J Obstet Gynecol Reprod Biol. 2010;151(2):203-7. [DOI:10.1016/j.ejogrb.2010.04.001] [PMID]
25. Shi X, Cui L, Zhang G, Shi Y, Wang D, Yang Z. Fast-track surgery after gynaecological oncological surgery: A Prospective Randomized Trial. [DOI:10.21203/rs.3.rs-22182/v1]
26. Shetty J, Gupta KS, Shetty A, Singh U, Kumar HA, Pandey D. Spinal Anaesthesia for Quicker Recovery in Fast-Track Abdominal Hysterectomy. J Clin Diagn Res. 2017;11(12). [DOI:10.7860/JCDR/2017/28884.10920]
27. Cui L, Shi Y, Zhang G. Fast-track surgery after gynaecological oncological surgery: study protocol for a prospective randomised controlled trial. Trials. 2016;17(1):1-7. [DOI:10.1186/s13063-016-1688-3] [PMID] [PMCID]
28. Borendal Wodlin N, Nilsson L, Kjølhede P, group Gs. Fast track abdominal hysterectomy. The impact of mode of anaesthesia on postoperative recovery-a randomised clinical trial. BJOG. 2011;118:299-308. [DOI:10.1111/j.1471-0528.2010.02697.x] [PMID]
29. Nilsson L, Wodlin NB, Kjölhede P. Risk factors for postoperative complications after fast‐track abdominal hysterectomy. Aust N Z J Obstet Gynaecol. 2012;52(2):113-20. [DOI:10.1111/j.1479-828X.2011.01395.x] [PMID]
30. Balayla J, Bujold E, Lapensée L, Mayrand M-H, Sansregret A. Early versus delayed postoperative feeding after major gynaecological surgery and its effects on clinical outcomes, patient satisfaction, and length of stay: a randomized controlled trial. J Obstet Gynaecol Can. 2015;37(12):1079-85. [DOI:10.1016/S1701-2163(16)30073-1]
31. Tavasouli F, Tavasoli Ar, Vahid rf, Tavassoli s. A comparison of safety and efficacy of early and delayed oral feeding after abdominal hysterectomy. Iran J Obstetrics Gynecol Infertil. 2005;7(2): 91-5.
32. Lin E, Calvano SE, Lowry SF. Systemic response to injury and metabolic support In: Brunicardi CF, Schwartz S, editors. Schwartz's principles of surgery. New York: McGraw-Hill Professional; 2015. p. 31-5. 33. Ashrafganjoei T, Khosravi D. Fallopian Tube Prolapse After Hysterectomy: A Case Report. J Obstet Gynecol Cancer Res 2017; 2(3): e59240.
33. Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. Bmj. 2001;323(7316):773. [DOI:10.1136/bmj.323.7316.773] [PMID] [PMCID]
34. Fanning J, Hojat R. Safety and efficacy of immediate postoperative feeding and bowel stimulation to prevent ileus after major gynecologic surgical procedures. J Am Osteopath Assoc. 2011;111(8):469-72. [DOI:10.7556/jaoa.2011.111.8.469] [PMID]
35. Whitehead WE, Bradley CS, Brown MB, Brubaker L, Gutman RE, Varner RE, et al. Gastrointestinal complications following abdominal sacrocolpopexy for advanced pelvic organ prolapse. Am J Obstet Gynecol. 2007;197(1):78. e1-. e7. [DOI:10.1016/j.ajog.2007.02.046] [PMID] [PMCID]
36. Minig L, Chuang L, Patrono MG, Fernandez‐Chereguini M, Cárdenas‐Rebollo JM, Biffi R. Clinical outcomes after fast‐track care in women undergoing laparoscopic hysterectomy. Int J Gynecol Obstet. 2015;131(3):301-4. [DOI:10.1016/j.ijgo.2015.06.034] [PMID]
37. Patolia DS, Hilliard Jr RL, Toy EC, Baker III B. Early feeding after cesarean: randomized trial. Obstet Gynecol. 2001;98(1):113-6. [DOI:10.1097/00006250-200107000-00021]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License Journal of Obstetrics, Gynecology and Cancer Research by Farname Inc is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Based on a work at http://jogcr.com/.

© 2022 CC BY-NC 4.0 | Journal of Obstetrics, Gynecology and Cancer Research (JOGCR)

Designed & Developed by : Yektaweb | Piblisher: Farname Inc.